Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, CA 94025, USA.
Am J Addict. 2013 May-Jun;22(3):277-84. doi: 10.1111/j.1521-0391.2012.12018.x.
The present study is the first to explore links between PTSD and cannabis use characteristics immediately prior to a cannabis quit attempt, including motives, use problems, withdrawal, and craving.
Measures of PTSD diagnosis, symptom severity, and cannabis use characteristics were administered to a sample of cannabis dependent military veterans (n = 94). Hypotheses were tested with a series of analyses of variance and covariance and hierarchical multiple regressions with Bonferroni corrections. Analyses were conducted with and without adjusting for variance shared with substance use (cannabis, alcohol, tobacco) in the previous 90 days, and co-occurring mood, anxiety, and substance use diagnoses.
Compared to participants without PTSD, participants with PTSD reported significantly increased: (a) use of cannabis to cope, (b) severity of cannabis withdrawal, and (c) experiences of craving related to compulsivity, emotionality, and anticipation, with findings regarding coping and craving remaining significant after adjusting for covariates. Among the total sample, PTSD symptom severity was positively associated with (a) use of cannabis to cope, (b) cannabis use problems, (c) severity of cannabis withdrawal, and (d) experiences of craving related to compulsivity and emotionality, with findings regarding withdrawal and emotion-related craving remaining significant after adjusting for covariates. Thus, links between PTSD and using cannabis to cope, severity of cannabis withdrawal, and especially craving appear robust across measures of PTSD and analytical method.
The results of this study provide support for models that posit a pernicious feedback loop between PTSD symptomatology and cannabis use.
本研究首次探讨了 PTSD 与大麻使用特征之间的联系，包括使用大麻的动机、使用问题、戒断和渴求，这些特征均发生在大麻戒断尝试之前。
对一组依赖大麻的退伍军人（n=94）进行了 PTSD 诊断、症状严重程度和大麻使用特征的测量。采用方差分析和协方差分析以及层次多重回归（Bonferroni 校正）对假设进行了检验。分析时同时考虑和不考虑过去 90 天内物质使用（大麻、酒精、烟草）的方差共享，并考虑共病的心境、焦虑和物质使用诊断。
与无 PTSD 的参与者相比，PTSD 参与者报告了：（a）使用大麻来应对问题，（b）大麻戒断的严重程度，以及（c）与强迫性、情绪性和预期有关的渴求体验，在调整协变量后，使用大麻应对问题和渴求仍然具有统计学意义。在总样本中，PTSD 症状严重程度与（a）使用大麻应对问题，（b）大麻使用问题，（c）大麻戒断严重程度，以及（d）与强迫性和情绪有关的渴求体验呈正相关，在调整协变量后，戒断和与情绪有关的渴求仍然具有统计学意义。因此，PTSD 与使用大麻应对问题、大麻戒断严重程度以及渴求之间的联系，在 PTSD 的测量和分析方法上都具有稳健性。
本研究结果支持了这样一种观点，即 PTSD 症状与大麻使用之间存在一种有害的反馈循环。
